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Saturday, December 1, 2018

118



This was originally published here, in French (link).
We provide this translation for your convenience. Practical aspects may differ where you live.




Blocking storagePar

Charles-Edouard!

Times are hard: not for everyone...


This story of intermittence is the example where the voluntary submission of some (poor 7/7!) makes the joy of the parasites: the medical-pharmaceutical underworld. The submission to the tax of the masses makes the happiness of the beneficiaries of the suppression of the tax. Diesel tax vs ISF. Everyone will have understood. Finally!

Go and participate in the yellow rallies, to get to know each other. What I saw there? A lot of retired people, thirty years old, fathers or mothers of families, very very majority coming from the provinces: they are lost, asking for their way.

A gay activist, or pretended to be one, hostile, came to explain to us that the gay community, and Parisians in the broad sense, hate the yellow vests. Worse, that without the gay community, it is illusory to count on Paris. The lack of Parisian support is glaring, deafening. Just look at these Parisian socialists. Hidalgo talks about the deplorables, a bit like Clinton did in his time. Adios...

The Diesel Tax is a Gay/Bobo Tax


The lack of support from the gay community is sobering... The Diesel tax is a Parisianism: it is a Gay-Friendly tax... No... The Diesel Tax is a Gay-Bobo Tax

For the intermittence, it is also a little the case... The Parisian community, the weekend blowouts under CHEM, preached for their parish and staunchly supported Prof. Molina, who made Ypergay preferable to ANRS-4D. This is not just a personal issue: the 'community' has taken a dislike to intermittence. The community has taken a dislike to intermittence, and it is practiced there: it was the only way to recycle pills before PreP was reimbursed. Now that the little traffic on the rue des Francs Bourgeois has been put to an end, one might have hoped that the community would finally come to the rescue of real patients. This is to forget that the U=U has completely finlandized the seropos, who no longer have a voice in the subsidized associations.

From here, I am the witness of it! My readers are provincial and in parity. And of support, none!

I am doubly aware of this in the preparation/writing of the OMNIBUS-3D essay: a real long-distance and obstacle course. All the more so since, personally, 3D is already far behind me... We'll see... There are things that are progressing well, I'll come back to that... Overall, it's quite positive!

This to underline that the famous 'community' is rather a ball and chain... Just like the consumerist Parisianism is opposed to the yellow vests.

Well... Let's go back to the blockade


Paris was deserted, the distributors empty or barricaded, all the stores wrapped in plywood. Total loss of turnover. Quatar, owner of the 'department stores' and de facto employer of the ruling clique, will not be happy (already that the barrel has dropped by almost 50%). Neither will Hidalgo. Neither will the profiteers of the LGBT distress.

In short, the success was total. Nothing to say. Act V will happen, for sure!

Gassing


The only slogan that was taken up was 'Macron Resignation' and a 'to arms citizens' all the more pathetic because the onlookers were defenseless in front of the rhinos.

The force charged, deliberately, for no apparent reason and caught the lambs in the trap: a blockage at the top, an armored column that around 16:00 goes back up to the pace!

I took a picture of it, petrified as I was between the desire to heroically block the race, and the concern to preserve my projects. The picture doesn't show it, but they are moving forward at full speed: look and count the feet. Never will we have drunk such repression! (see the guilty indifference during the reactionary demonstrations against marriage)

The trap was set, the boulevard, emptied ... A real boulevard for the charge. I recovered the yellow victims a little lower down, quite innocent, an eye cleaner as only relief. They won't let themselves be fooled twice: you can 't clump together in one place, you have to be everywhere and nowhere at the same time.

Storage


This case is not good news, and a call for a general strike would have enough support to disrupt the proper delivery of ARVs, all of which are imported.

Such a signal would do us good! There is no need to go on and on about hoping for the worst: hope is not a strategy. The strategy is to have stock, for yourself and for others. I have stock, for myself and for my friends, only... The obvious lack of support from the 'community' having been well noted.

By the way, I don't take my meds at the pharmacy in the right proportion, but like everyone else: there is nothing to gain by lowering the pressure on a corrupted system. Especially since there is no 'official' accounting that would allow to record the success of the intermittence.

Omnibus


The Omnibus project, validation of the 2/7 and exploration of synergies, is becoming more and more structured. Very soon we will be able to align 4 projects: - Omnibus-3D ; - Omnibus 3-2 ; - Omnibus 3-2-1 ; - Omnibus-bicycle (= 4/7 in Bi). Not too necessary to specify further: the name speaks for itself.
We see a support committee forming!

In the news


- The reimbursed condom!? As long as we have to do it, we might as well do it by halves: it will only be reimbursed at 60%, for one brand only, and it will be necessary to go through the doctor: ideal for PrePistes, probably ineffective for the average male... Can do better' mention


- Very good analysis ofEmmanuel Todd on the Yellow Vests.

The French genius


without comments...

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97% of patients overmedicated, 22 million without treatment... Let's stop this scandal!

Thursday, November 1, 2018

117



This was originally published here, in French (link).
We provide this translation for your convenience. Practical aspects may differ where you live.




The new dual therapies 2018

By Charles-Edouard!

The 2016 bitherapies, now validated


Yes, the 7/7 bitherapies are 'lightening', let's say a de-escalation, made possible with the arrival of DTG. Unlike intermittence, they do not bring you any closer to dynamic remission, unless you validate them in 4/7 mode (or better).

We have already presented DTG/3TC, DTG/RPV, DTG/F-3TC and NVP/RAL. Please read that post. In 2018, DTG/3TC (and a fortiori DTG/F-3TC) and DTG/RPV passed the validation tests, funded by the industry, with flying colors. The result is two co-formulated products: JULUCA ® (DTG/RPV) and soon DTG/3TC which is announced here, following the 2 Gemini trials, with 1400 patients.

Nothing new under the sun and our biotherapies of choice are validated, hurray! Well... Yes, because for patients who do not know the eclipse, the risk was to remain for years and years on superfluous triple therapy. Obviously, it takes the edge off the zinzins like Genvoya® or SYMTUZA® ; the transparency commission (HAS) has also rejected SYMTUZA® and Descovy® by giving them a shitty ASMR... Well...

3 new dual therapies


Today let's highlight 3 new bi-therapies. Indeed, the power of DTG invites clinicians to new approaches, including the question of the relevance of doses or other tricks (boosters)

Nevirapine 200mg + Lamivudine 300mg


Yes, the VerxVe trial shows that the admissible threshold is not 4,000 ng/mL as the Morlatexpert report still claims, without justification(and for good reason...). This leads to this terrible admission, found by chance, on the Saint Antoine assay reports:

In a word, the recommended dose of 4000 Nevirapine(though not whey...) is wrong by at least a factor of 4

Dr. Lanzafame had already reported great success with NVP 200 mg in maintenance. He went further and removed TDF (alternatively ABC), putting his 9 patients on NVP/3TC.

He reports on this in the article here:
'Deep' antiretroviral de-intensification, a strategy to avoid drug interactions and long-term adverse effects of HAART.

Obviously, compared to dynamic remission, this is a pity... But let's think about those millions of patients, often Chinese, on NVP, and who are worried about the use of TDF.

There are solutions, we must explore/validate them

It would be smarter, cheaper and easier to deploy than DTG/3TC, whose favourable price in 'poor' countries is still pending.

Efavirenz 200mg + Lamivudine 300mg: bis repetita and a surprise...


We take the same and we start again: this time with EFV 400 mg then 200 mg, with the suppression of TDF (or ABC): that's what makes you a low cost and low toxicity maintenance biotherapy. A wink to one of our readers who is concerned about this subject.

No need to switch all France from EFV to DTG

Lanzafame remains a pharmacokineticist at heart. Eclipse is not yet his thing, even if he is kind enough to cite ANRS-4D as inspiration, and to write:
The hypothetical effective concentration... My eye!

We ask the great chief of synergies (Aka Leibo) and we learn that Yes! EFV 200 mg is good! and in 1/7 what's more! (with TDF/F-3TC/DDI)... And even better, a patient of African origin (with the right cytochromes) does 1/7 with only 100 mg of EFV (in Quadritherapy)

Lanzafame, by pushing open doors, is not at the end of his surprises!

The end of the end: DTG/ATV, candidate for 2/7 (or even 1/7)


The question is how to use DTG in 1/7: it's not written on the brochure! in Mono-DTG, I don't doubt those who manage to do it; I didn't succeed(I may have made a mistake by putting it in a capsule, go figure...). DTG/3TC in 1/7 does not tempt me too much because in case of failure you get mutation 184, which you then have to clean by drowning. I don't have the time... So I had to find something that fits well... And there ATV is a very good candidate because it is a DTG booster, in addition to being well tolerated, at this homeopathic dosage (1/7...). For Leibowitch, it will be without the booster (ritonavir), so, obviously, it is attractive! The 2 highest barriers to resistance and a pharmacokinetic synergy at stake: here is a good candidate!

We mentioned it during our staff meeting at the Salpêtrière Hospital... And Pr Katlama agreed... So we keep him for OMNIBUS: it's my new hobby! Especially since I'm not done with DTG yet!

In fact, the only thing that bothers me is the DTG/NVP incompatibility: it's irremediable... Well, we'll see with the dodecatherapy, currently being explored, in view of the 1/15.

Finally, to have tried it, this ATV passes finger-in-the-nose: it is really a track to dig.

Bi and intermittence: comparative table


(added on 10/01/19) From DTG, there are 3 Bi options (DTG/RPV, DTG/3TC, DTG/ATV), and the question arises which one is the most favorable to intermittence. Note: the Bi + Intermittence coupling has only been explored by patients, in autonomous mode, or by Leibowitch. To date, the corresponding clinical trials are in preparation (OMNIBUS and OMNIBUS-Bicycle)
From NVP, there are 2 options (NVP/3TC, NVP/RAL). RAL is the source of the Achilles' heel, so it is not to be retained. NVP/3TC remains, published by Lanzafame.

I add (on 10/01/19) a comparative table:
Bi PillsSide effectCycle ExploredObjective Cycleled to 2/7 ?trial plannedpreference
DTG/RPV1Yes (psy)not tested4/7NoOMNIBUS-Bi
DTG/3TC1No4/7 (stand-alone)4/7Yes (*)OMNIBUS-Bi
DTG/ATV2No2/7 (Leibowitch)2/7yesOMNIBUS-2D
NVP/3TC2RareNo4/7?Yes (*)OMNIBUS-2D
NVP/RAL4YesNoNoNoNo

Yes (*): with TDF added

Charles-Edouard! The Book...


It's not going anywhere, because I'm in charge of OMNIBUS and you can't write history and tell it at the same time, Ah, well... Yes, we can. Well... I don't have time...

In the news


- read this article with interesting data on the Eclipse; it dates from 2015 and has data on a whole population of patients, not only 'top' patients; and the eclipse, relentlessly from 15 to 21 d....

- you can learn a lot from this article: Is dolutegravir pricing fair? A comparative analysis of price and country income level in 52 countries

- another interesting article: Risk of Viral Failure Declines with Duration of Suppression on HAART, Irrespective of Adherence Level: it shows that, after the first 1-2 years, the risk of rebound decreases even with poor adherence: this helps to explain, graphically, why it is necessary to wait for a year of undetectability before starting 4/7

- after the Levothyrox scandal, here is Androcure, and a new brutalization/medicalization of the woman's body.

The French genius


I like Nolween Leroy, here with Renaud Capucon, in the mythical I'm calling you (Bagdad Café)

The prize goes to J.P. Gaultier and his brilliant Freak Show! The ICCARRians will pay attention to every moment: a surprise awaits them, in the form of a wink, which will warm their hearts. Many thanks to our national Jean Paul, of whom we are so proud! See the trailer here, and enjoy it for the holidays!

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good weekend, good stuffing and not too many meds ... Huh?

Monday, October 1, 2018

116



This was originally published here, in French (link).
We provide this translation for your convenience. Practical aspects may differ where you live.




Catching up

By Charles-Edouard!

Under Eviplera, this one didn't understand anything. Look for the error...


Why believe that there is a logic? The virus, once flat, takes time to resume its replication. The first? Does it speak to you? It's 2 to 3 weeks before the virus makes its nest. The eclipse is 2 to 3 weeks before the virus re-establishes its nest. There, he does dose reduction. He is a pharmacokineticist, an idealist, who believes that the world conforms to his idea, his logic. No! The virus has this observable characteristic: it starts slowly. Our pharmacodynamic strategy: a bomb, then silence... Then a bomb, then silence... Then a bomb...

No submission, no expectation, just a strategy


The virus was not created to punish us, it evolved... It's a do-it-yourselfer, which somehow survives. And when you understand your weaknesses, you take advantage of them, and when you don't understand, you submit to the dictates of accredited crooks.

When, in experimental mode, you fail, you are not punished: you learn! I did my failure, reported here, wanted, not desired . Where we understand that Mono-DTG is not a good vehicle to embark on the legitimate pursuit of remission. Well... We have before us a failure with many zeros, and we need a strategy, challenge launched here, which no one has taken up: Which strategy to choose? We have 3 at hand:
A- drown to start again on a healthy basis
B- re-enter the treatment with: B1 - DTG; B2 - without DTG

Strategy A: Drown


This is part of the forgotten knowledge of virologists: in prolonged cessation of treatment, the historical virus, more active, resumes, over time and replications at the arigot, the space at the expense of the mutant, who, from marginalization to marginalization, is eliminated. It can't be done in 5 minutes or in 2 months (oh the twist that this 'test' caused us with 2 short months of fallow): it's 6 months minimum, 1 year or more, please! And it cleans the resistors well... But hey, there under Mono-DTG (1/7), what do we want to clean? We're not even sure there's anything to clean up... Well, that means a year or more behind our plan to get back to 1/15. On the other hand, for suspenders and belt, it's perfect because drowning works!

An advantage to be credited with stopping treatment is that the PTC profile (those who control after interruption) is not obtained immediately: it takes a few months before the immune system takes over and masters the situation. It exists, but rather rare. And overall less attractive than the 1/7 or the 1/15

If we don't drown, there is still a hint, which will have to be taken into account for the shock combo for the 1/15.

Strategy B: resume treatment


Still, the goal of the game is to stay on treatment, especially since the objective is to redo the 1/15, ie a very non-intrusive treatment. At this rate, it is in our interest to stay on treatment, even if the interruption remains an option. For the recovery, in the event of failure with the reduction, there are in fact 2 schools: resume without DTG and resume or recycle with DTG. In resuppressing without DTG (i.e. considering that DTG is no longer an option) we find Katlama, Bart Rijnder (DOMONO) in resuppressing with DTG (it is considered that DTG remains useful) we find Martinez (Barcelona) or Lanzafame (Verona). Surprisingly, Leibowitch re-deletes without DTG but reuses DTG afterwards in an innovative approach that we will see later. To all the morons who only know how to dwell on 'trust your doctor' we want to answer: 'But which one?'.

One advantage of going back with DTG is that we would learn something. If we resume without DTG, we close the page, we move on, then considering DTG as lost forever... Ah still the dilemma is important

So you... how would you do it? Ah you are right, we should do a risk analysis with regard to possible resistance. We'll see about that next time... (there, I'm a little stuck on a lot of projects)


In the news


- Broad-spectrum monoclonal antibodies: this is a trending topic from which we think we can expect a lot: A. Faucy explains here in video. I will try to do a post on the subject, because the implications for our search for remission seem important: we must start to take an interest in it!

- Top Fools 2018: To 'prove' that Gilead's all-in-ones don't induce insulin resistance, 'scientists ' have put the means!
Effects of F/TAF, E/C/F/TAF, and R/F/ Combination Antiretrovirals TAF on insulin resistance in healthy volunteers
They tested patients before and after... How many patients 1000? 100? ... no... 10. For how long ? 2 years ? 2 months ? ... no... 2... weeks!
And with that all the usual bullshit assholes will trumpet that no, Oh no, no risk of diabetes with our wonderful pills: tasty!

The French genius


Oui, Charles va nous manquer!. Heureusement ses chansons nous restent dans la tête comme autant de rengaines:
I live alone with mum
In a very old apartment
Sarasate Street
I have to keep me company
One turtle, two canaries
And a pussy
To let mom rest
Very often I go to the market
And the kitchen
I tidy up, I wash, I wipe
Occasionally I also sting
By machine


Go on! A little balm in the heart with this playful interpretation of Vivaldi by 2 Frenchmen in a dress bedroom.

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have a nice weekend, good fun and not too many meds... Huh?

Sunday, September 2, 2018

115



This was originally published here, in French (link).
We provide this translation for your convenience. Practical aspects may differ where you live.




Omnibus at the Salpatrière!

By Charles-Edouard!

It's going well for our friend Joëlle:

First of all, we're happy for you, and as far as medical follow-up goes, look what happens:

Charles-Edouard! and OMNIBUS at the Salpêtrière


The excellent seminar at Pasteur gave us a boost. As ANRS-4D has a 100% success rate in compliant patients, what can Quatuor bring if not a confirmation? At worst, there will be some failures, but so what? We will be able to better circumscribe the eligibility... The procedure is 100% risk-free. We already know that it is 100% without damage or after-effects: a simple return to 7/7, with the same combo, is sufficient, without prejudice.

Quatuor has a mandatory checkpoint, in a few weeks. They are going to publish an intermediate assessment to authorize (or not) the candidates who have been willing to stay in the delayed arm (7/7) to switch to 4/7. We will then know how many patients, in the 7/7 arm, have sent the ANRS packing by switching, on their own, to 4/7, since it is... authorized by Morlat!

The whole of Paris that counts expects excellent results. In particular, the Salpêtrière, which has provided the largest contingent, and therefore has a good idea (patients and practitioners know which arm they are in). Quartet or not, we have the wind in our sails, and it's not to go in circles!

Leibowitch considers himself out of the game because of his age, and wants to pass the baby on. In order to give credence to this retreat(do you really believe it?), he has effectively worked to open up a presentation opportunity for us at the Salpêtrière. The echo of our success at Pasteur comes back to sensitive ears.

So here we are, invited by Pr. Eric CAUMES, to a presentation, a staff, on Thursday 27th. We don't have long to convince, but we start to be a bit broken in.

Between the initial plan, the modifications of summaries, the slides reviewed, then corrected, then rewritten, the rehearsals, it took us 4 full days to work on it: the public and the stake are not the same!

ICCARRE is a clinical concept. At Pasteur, they are a bit virginal, but not at the Salpétrière!

A large audience


A presentation by Leibowitch, that attracts! And there, you had the bench and the back bench of the whole Salpêtrière, clinicians, virologists, interns, externs, employees of the industry(sic). In short, it was anything but intimate. If some people had come for the clash, they still got it, a little!

We had come with our die-hard supporters, and fortunately! We were playing outside. On the Salpé side, at least fifty white coats: it's the biggest hospital and university center in France! (of Europe?)

Well, for the atmosphere, let's say frankly that we were received with professionalism and courtesy. This is important because the debate was intense, and the firm organization of the speech a perilous exercise and, let us say it, successful.

Presentation in three parts: Leibo, Ch-E, Leibo


The presentations will be online soon. You too will be entitled to the content.

Leibowitch started with a trick: he won't say a word about 4/7, it's a done deal, and that's not the point. He presents his clinical cases: there are a good fifty patients at 2/7 (including twenty at 1/7). That's a good picture!

Then he passes the floor to me for a mini-presentation: Dynamic Remission and Omnibus: Showing that the Eclipse exists, its dynamics, introducing dynamic remission and the (new) notion of Distance, OMNIBUS and our projects.

As you will have the slides and the topos, I won't go into too much detail... OMNIBUS? It's a validation test of the 2/7 followed by an exploration of the best synergies.

Then Leibo takes the floor again to make the case that it's time for distinguished clinicians to take over. At almost 85 years old(he says... ), he wants to pass the baton. So it's up to you to step up to the plate.

A passing exam


The reader must understand that we are dealing with experienced clinicians. You mess up on an argument, and you're finished... I know my subject well, but not everything, and they ... Yes, I do...

I mention the Visconti... And then Prof. Katlama interrupts me to ask me to define what the Viscontis are, in case there are people in the audience who don't know. Well, I'm doing pretty well, and I'll put the nail in the coffin: all attempts to recreate Viscontis (e.g. SPARTAC trial) have failed. As in the circus, the gladiators test themselves.

Small point of semantics


I mentioned that from now on we would call 'dynamic remission' what is at 1/7 (or even better), and nobody noticed... It seems to pass.

Since there are now so many proposals on the table, it was agreed to call from now on what has less molecules and intermittence, the x/7. Yes, because otherwise it is confusing! We learn, in passing, that the Salpé has about fifty patients on Mono-DTG, without any problem...

A lively debate, stormy at times, and an ultra positive conclusion


Under the firm direction of Prof. Caumes, Prof. Katlama takes over. Well... She is in front of her troops, so she paints us a pro domo picture, where the Salpé is portrayed as a proactive actor: 1/3 of patients are on lighter prescriptions. Well... We came to give the keys of the city to Caesar, so it's in the right order...

There are still some who are bothered by ICCARRE-le-Grand. Virology is the first one to shoot, and the reservoir's patati and patata. I'm taking out my public challenge: prove, by a contingency table, that total DNA is a predictor of the Eclipse's closure. I know there isn't one... But then, Katlama, reports that in MONOI there was only one real failure, but a few blippers, in whom there was a small reservoir effect, which is normal and expected, according to her.
No need to raise. That doesn't answer my challenge... Especially since she could have used her ULTRASTOP test, which she didn't do, and which reinforces my idea that there was little argument to be found there... Huh? Well... Now we've kicked you out of the total DNA with a big kick in the pants.

Roland Tubiana noted that I had presented advantageous openings of the Eclipse, measured in very early treated patients, with low reservoir. This is factually correct! We don't point out, because in fact, we can't do anything about it... The tendency, among the few clinicians who do analytical interruptions, is to choose favorable patients a priori, so as not to get too bored... We don't have recent values on 'broken arms', but we have 20,000 weeks at 2/7 (or even 1/7)! That's 20.000 eclipses, of at least 1 week, repeatedly!
So as long as the eclipse is of more than one week, whether it is of 7, 15, 21 days, we don't care a bit, for the subject of the day.

Then he laid out a known speculation, that even below the threshold of undetectability, things might be happening and that, well, there you go, that might sustain some replication and inflammation, what do I know.... What do I know, indeed... It's Nessie, the Loch Ness monster, we've never seen anything, never proven anything... It is purely speculative...

So it's a bit annoying, for nothing... But well... Leibo, he likes to show off, and the young interns who dreamed of a clash have been served. It's even better than at Bourdin or Ruquier. And then, it was the language of a rifleman! Well... Let us pass...

In fact, the bottom line is that Katlama, the story of an OMNIBUS trial at 2/7, likes it... That's it! We had plenty of marbles, arguments, pleas, but, in fact, useless: OMNIBUS pleased!

We had presented it in broad strokes, so she asked us to refine our project.
That was all! It lasted an hour, and it was agreed that we would refine OMNIBUS, and follow the usual path.

A success... I'm proud of it!


For a success, it is a success. Since it was bibi who presented it, I was a bit surprised: it went through like a charm(well... it will do... ). Well, after 4 days of preparing a nice shot in the cage, it took me 3 days to recover!

I'm exhausted... More in the next issue!

Have a good weekend, good stuffing and not too many meds... Right?

Saturday, September 1, 2018

114



This was originally published here, in French (link).
We provide this translation for your convenience. Practical aspects may differ where you live.




Misconceptions 2018

By Charles-Edouard!

Hello Charles,

I see your testimonial where you say you blew your copy counter and lost 500 CD4s. Quite surprising, how do you explain it?


It was a trial with DTG 150 mg, 1 day out of 7: the rest in a future post... Don't worry... I became undetectable again quickly and my CD4 came back to 950 immediately (after a step at 700)
In my case, the CD4 count is yo-yoing: sometimes I lose (or gain) 300-400 CD4 even in stable periods, while keeping a rather stable percentage... The blood counting machine does not count CD4, no... It counts the lymphocytes and determines the percentage, then it simply multiplies it. When you are in the high percentages, the slightest fluctuation in the total number of lymphocytes, arithmetically, causes a big fluctuation in the count. One day I will do a paper on the subject: the fluctuation is natural, and it is the absence of fluctuation that is not...


Misconceptions 2018


Whether writing The Book or preparing for our conferences, I find that I have to fight a bit of the same ideas that are at the root of excessive and unnecessary over-medication. These ideas, promoted by a corrupt system, end up being an obstacle to research and to a better quality of life. Just like the list of doctors or drugs, I want to make a list, to comment it and to see what changes from year to year...

The opportunity is given to me by the appearance on youtube of such an attempt to drown the judgment of the patients in an endless, useless and especially... false logorrhea.

Of course, there is no lack of misconceptions around the world: religion, homeopathy, integrative medicine, Keynesianism, the European 'nation', creationism, cholesterol, etc. It is even fun to dissect them. It is even fun to dissect, with precision, in order not to be accused of conspiracy or arrogance, which are the tricks liars use when they are pushed to their limits...

How to spot a misconception in modern medicine


All this junk is not medical in the noble sense and is treated as risk management, something people do on a daily basis, sometimes like Mr Jourdain, without knowing it.

Philosophers have developed Logic to serve as a tool. Now, we must be open to other tools. For the most banal deceptions, Atlantis, the black cat, etc., follow Michael Shremer who reviews the bullshit detection kit. In modern medicine, we have a wonderful tool: the contingency table, well explained at the beginning of this video.

In all circumstances, ask for the confusion table (see Wikipedia)

List of misconceptions


Here is a list of common ideas that we will see how (or if) they are invalidated:
Pharmacokinetics, Total Proviral DNA, Abusive Indication Extension, Achilles Heel, Bombology, Honesty of Scientists, that will be plenty for today...

Chance, you can go and watch this ultimate of stipendiated deception that is HIVonAir, and I even recommend this episode Is it possible to eradicate HIV from the body of an infected individual? by Dr Laurent Hocqueloux , Dr Anne-Geneviève Marcelin , Dr Gilles Peytavin , Pr Gilles Pialoux

Here we see Pharmacokinetics (Dr Gilles Peytavin) and Virology (tanks, Dr Anne-Geneviève Marcelin) summoned to the debate on the question of remission, displaying their knowledge, without advancing things one iota!

What is (total) remission? It is an eclipse that does not close! So any discussion about remission is a discussion about the closing of the Eclipse(its opening, at CV < 50, is a given, it opens every time)

Pharmacokinetics: it's pathetic


gilles peytavin vih pharmacocinétique
Pharmacokinetics is a useful science, when invoked properly! Since the Eclipse lasts on average 14-21 days, starts with a 1-2 day pharmacokinetic extinction phase, explain to me how pharmacokinetics has a role to play in the end of the eclipse? It's impossible because, from the middle of the Eclipse, there is nothing left! And if someone insists, insist on a confusion table where PK is able to predict anything about the end of the Eclipse: This is the public challenge to Gilles Peytavin: show, by a confusion table, that PK is involved in the end of the pharmacodynamic window (the Eclipse).

And if you can't do it, please go back to your studies and don't bother the debate anymore: it' s pathetic.

We don't care whether a viremia leaks into the sperm a little, a very little or a very little: this is the strength of the Swiss statement, clinically confirmedto affirm the non-infectivity, notwithstanding the possible presence of viremia in the semenso we don't care. And it has nothing to do with the closing of the Eclipse! Goodbye Berthe!

Proviral DNA: off the track


anne geneviève marcelin vih reservoir
Rouzioux has been pumping the air for more than a decade to make us believe that proviral DNA is predictive of anything. She recently added another layer here: this marker is easy to use, precise, specific, practical, robust and reproducible. Let's comment: easy to use(yes, so what?), accurate(oh really? +/- 1 log , is that accurate?), specific(of what? with more than 95% of Junk, unable to replicate, it is specific of what?), practical(yes, so what? practical if it doesn't bring anything, what's the point?), robust(well, come on! prove it!) and reproducible(yes... it's also a characteristic of systematic errors to be reproducible). A good measurement must be accurate, faithful and sensitive: but this thing has no sensitivity! You might as well weigh a coin with a weighbridge!

This is what Anne-Geneviève Marcelin demonstrates with her onion diagram, which must be read with a Log scale in your head

By the way, ask for the confusion table: in ICCARRE 1/7, ANRS-4D, SEARCH 019 it is impossible to establish! To be a predictor of failure in short or ultra short cycles, there would have to be failures! Oh yes, it is a poor predictor in an equally poor alleviation: the Mono-IP. How does Mono-IP contribute to the remission effort?

This is the public challenge to Anne-Geneviève Marcelin: show, by a confusion table, that the total proviral DNA measurement anticipates the end of the pharmacodynamic window (the Eclipse). And, if not, go back to your studies, without stuffing us any more. Thank you very much...

Well... You remember the famous 'Rouzioux criteria': not one of them has withstood ANRS-4D: laminated. So, we hope not to see it again on our screens!

the Abusive Indication Extension: inexcusable torture


The U=U is a valid argument to present to the patient who is reluctant to enter treatment, in the absence of even mild immunosuppression (CD4 > 350). And if this is not a concern, it is criminal to impose a treatment without demonstrated benefit.

The START trial, where all the excess morbidity occurs in the countries of the South, whose sanitary conditions have no comparison with those of the North(go and catch tuberculosis in Sweden or a fatal salmonellosis in France, it's ridiculous!), demonstrates, contrary to the vulgate, that the over-risk in the North is null: indeed the over-risk is exactly proportional to the real over-risk in the South (TREMPANO) and the null over-risk in the North(HIV-CAUSAL)

Here again ask for the confusion table! That of the North, of course! The risk in our over-aseptised countries is out of all proportion to that in Zimbabwe(who would be stupid enough to believe it?).

You are promised a better immune restoration to enter the treatment (too) early: here too, demand the confusion table! Yes, the confusion table! Because no one ever gives it! And for good reason!

The Achilles heel: a concept to be invalidated


The Achilles' heel(I named it that) is a weakness in DTG induced by the previous use of RAL or EVG. This risk factor is amply confirmed (BMM+P cohort) and even confirmed(sic), a little late, it is true, by the authors of DOMONO!(resic). So it is not a false idea! But it is a not very specific predictor. Sensitive, but not very specific. It is a predictor that can be read in the patient's file. Yes, it is. But the virus doesn't have a periscope to read, over the virologist's shoulder, what is in the file! It only knows how to 'read' DNA. The day we will also be able to read and predict, with more specificity, that day, the Achilles' heel will be obsolete. Until then, it remains the best we have! But you still have to take the trouble to read the file... Hein Hoqueloux, you've been fooled on this one...

Bombology: we just have an embryo


When the Eclipse closes, it is the end of the mini-remission. It closes around 14-21 days. , on average. For some 7 days, 30 days for others. Therefore, at 1/7, we are in no-failure mode, and who cares about having a predictor? At 1/7 we are in the white zone, the comfort zone. As the search for dynamic remission is a Darwinian process, when the patient's rhythm changes from 1/7 to 1/10, 1/15, etc., we will eventually enter the grey zone. And there, looking for a predictor makes sense.
Well... At 1/7, pharmacokinetics is in the toilet... I get it... Measuring the reservoir has a very small chance, very small unless you use another method than proviral DNA, as easy as useless... Achilles? We don't really care... Mono-DTG for 1/15??? I don't feel it... But well, the proposal exists, so we'll see. There is still the 'Science of Bombs': in Choke-and-Mute, we vitrify the system with a mega-bomb, and then we take advantage of the Eclipse. How to build a mega-bomb? A weak bi (DTG/3TC) a concrete bi(DTG/XXX, I'll come back to that soon), an unexpected TRI (NVP/DTG/X), the patented Quadri, the Dodecatherapy(I'll come back to that soon)? There is bound to be something that is better than another. In any case, Isentress®, we don't feel it... Kaletra® ??? It's not a done deal!

So for the moment Bombology, the 'Science' of the best synergies, is a bit of alchemy. We are already lucky that the Leibo patent works, but if we no longer have Videx® or if we are allergic to Abacavir, we have to find something else!

So Bombology is a technique to be developed, we need people, ideas, money and volunteers(in large numbers), we will get there. And then, one day, someone will come up with a concept that will invalidate this trial and error research.
So, it's not a bad idea, but we'll have to do it right...

I forgot about Septism: what was I thinking???

It's true that with the announced success of Quatuor, we just forgot that this nonsense had also made its time. We will develop in 2019...

The honesty of scientists? In this mercantile era ???


Here again, if you are not already disillusioned, watch again HivOnAir® or the Rouzioux video! It's so distressing that you could cry. Everyone has their own little ditty, the one they know, the one they get paid for. Look at how Peytavin embarrasses even his own colleagues in this golden galley! He can only tell you about what he knows. But is it relevant to the case? No! Then it's talk for nothing. The mistake is not Peytavin, as a person, the problem is to summon him to a debate where he has not contributed anything. But this choice is not trivial: it is motivated.

So, to see the patients, in suffering, being bamboozled in this way, yes, it is sad... The honesty of scientists? A misconception!!!

In the news


- U.S.: 72,000 people died of overdoses in 2017, a record. It's the opioid crisis... And who is it that put this on the market? And who's the one who authorized it? And who is it that prescribed them? You criminals!

- Oh, this is not recent, but the subject is fascinating: When Snails Attack: The Epic Discovery Of An Ecological Phenomenon

The French genius


The genius of the week is Charles-Edouard! You are never better served than by yourself... Honestly, I had a great time watching this conference at Pasteur!
It is now available on YouTube. That's it! We know how to do it too!

Video in 3 pieces:
Part 1
Part 2
Part 3
And the: Verbatim

Otherwise, have a nice time with the choristers, on video: a treat...

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97% of patients overmedicated, 22 million without treatment... Let's stop this scandal!

Thursday, August 2, 2018

113



This was originally published here, in French (link).
We provide this translation for your convenience. Practical aspects may differ where you live.




Mono-DTG 1/7 (150mg): failure rectified

By Charles-Edouard!

Question read on Doctissimo, from a thoughtful friend


First there is some confusion... Her friend does 1/2 (discussed here). It's not ICCARRE: as for the questions she's asking, they've been answered in the FAQ of the Practical Guide: yes, you can do ICCARRE after having come out of an AIDS stage, and yes, you can easily catch up in case of failure (rare) while remaining on the same therapy.

Mono-DTG 1/7 (150mg) : failure ...


When you do experimental work, you have to go slowly, step by step, and only stop when you fail (when the level rises above a certain threshold). I don't do things by halves, I change my mind as soon as it goes up, even if it's wrong... So I had some small failures, like my failure at 1/27 (150 or 200, I don't remember)... It had worked well until 1/24... Well... Too bad, I would have liked the 1/30... Anyway... Well... My attempt of Mono-DTG, 150 mg in 1/7 has been blown up... And not only a little! Here we change scale.

Usually, I do my CVs conscientiously every 2 months. Except that here, very rarely, I find myself stuck abroad-not cool: no self-service CV on the horizon. I waited... No luck, just at the crucial moment. Well, as a result of all this, I blew up the counter! First of all I blew up my personal counter, my zenith went full speed towards the North. I was a bit surprised but not too much: my natural defenses have not seen the virus for a long time. Now they are caught off guard. And I really blew up the counter: I have more copies than all the published failures in Mono-DTG combined (BMM+P & Domono, plus all the little tests): I'm doing more than 50% on my own! That's to say that it was a heavyweight!

Well, I'll stop the giggling right now, this case is behind us, and well... So let's stop giggling and silently watch the Master who will show you how he managed all this like a boss, finger-in-ze-nose.

I lost 500 CD4s! So what?


I stop answering to the whiners who squeal when they have lost 50 CD4, it's just rubbish. But 500! That's when you've got to put your man down!

You have to have 500 to lose, that's for sure... With my years of lightening, everything is fine on this side: I usually have around 1000. So even with 500 less, we are far from the (mini) risk zone, which starts below 350, as everyone knows(except for the idiots who think that you can catch tuberculosis, salmonellosis or e-coli in a healthy environment).

This is an opportunity to remember that, for the average patient, when you take the virus out of its pharmacological cooler, you are back to where you started, quite quickly. That's why we don't do experimental racing with a Nadir on the floor... On the other hand, ICCARRE 4/7 can be done, since it is no longer experimental.

And I never miss an opportunity to remind that total proviral DNA is anything but a reliable measure of the reservoir, yet it exists... After all, I was the one who first named dynamic remission, thinking that it is a bit illusory to hope for better, for the moment. So read again Segal's famous article : The problem of HIV persistence despite antiretrovirals(which really annoyed Siliciano... Hi, hi, hi... )

Well, come on... We'll catch up with it, no problemo


Enough whining, let's make up for it... Well... at least between Mono-DTG and the good old combo-Leibo to make the 1/15, there is no photo... So, anyway, we would have gone back to the good old tried and true methods. Even the 1/7, it bores me... And since I'm the one who formalized the Choke-and-Mute, on a Leibo-Sonigo intuition, it would be nice if I were a bit consistent with myself.

We have no tools at hand, no genotype, nothing, nada. We're going to work out a strategy, robust while being blind, so we're going to use our neurons and what we know otherwise.

Which strategy to choose?
Well, we have 3 strategies at hand:
A- make a drowning to start again on a healthy basis
B- re-enter the treatment with:
B1 - DTG
B2 - without DTG

Here is the problem you can think about: what would you do in my place? Go ahead... Pros and cons... Have some fun... You'll find out...

We'll see how we did it and why, next time

In the news: everyone wants to kill the HAS


The medical-pharmaceutical underworld has mastered registration with the FDA and has shaped the EMA into a costly but docile re-registration chamber. useless.

All the more so since, afterwards, it is necessary to go back to the bar: in Germany, in the United Kingdom, etc. And in France(ouch!!). And in France, there is the transparency commission: a revolution, a great achievement. Well... They want to kill him... And Juncker, that crook, sold it to them:

Trump's Verbatim:


According to the Dow Jones, it is align standards on pharmaceutical products ...

On the side of the commission, the question of soybeans is minimized, almost 'anecdotal' according to the commission, but quite strategic for Trump: indeed 95% of American soybeans are GMO and rotten with Glyphosate: how can we ban glyphosate (RoundUp) with one hand and massively import glyphosate soybeans with the other?

The real question is the harmonization of marketing authorizations (and prices... in the minds of Americans...)

Juncker is a crook... Who did he swindle? Trump? By promising him what we can't deliver? Will France stand up to the enormous pressure to make us swallow American crap at a low price?

The Transparency Commission (HAS) has rejected SYMTUZA® and Descovy® by giving them a shitty ASMR... Well... They could have looked at Isentress HD®, but that went under the radar... ASMR in shit... Well ... well, at leastthat's it...

Oh well, no... The obscure transmission belts, exactly what the commission of transparency is used to fight, start to work and here we are with a firework of vitriolic communiqués by the usual bouzigues: TRT-5 and SFLS, all these kindly sponsored people... Pffff... And never a single patient case to highlight, of course...

The HAS emphasizes the existence of alternatives in case of toxicity. One of the arguments of the puppets is to say: 'look at that! It is authorized in Germany, in UK, etc...'.
'France would thus be one of the only two countries in Europe to have this situation', the SFLS notes, amazed.(Oh the beautiful argumentation!). Certainly, but the argument of the HAS is the existence of alternatives to toxicity... And as an alternative of choice, there is relief... And this does not exist in Germany or in England and even less in... USA! Nor... in the SFLS, as you can see...

So, when we no longer have the transparency commission, we will only have the opacity of Washington, and then we will suffer...

Other news: it's back to school!


- Several times we asked the question: can we do better than EFV 400 mg, for example 200 mg? Well, Lanzafame has done it... And he took the opportunity to withdraw TDF (or ABC), that is to say EFV 200 mg + 3TC 300 mg 7/7 with as an alternative NVP 200 mg + 3TC 300 mg. It is here; we will come back to it!

- Moncay's results are in line with all the other trials not taking into account the Achilles heel: it's a disaster... Cata announced by Katlama... Cata inflicted to the patients... Pffff... We would have liked to believe that Hocqueloux was smarter than Raffi. We are disappointed... But Mono-DTG, at Lanzafame, still works well...

- This publication by Molina: Doxycycline prophylaxis for sexually transmitted bacterial infections: promises and dangers. It's a debate... Paris now has a whole school of doctors, once fervent activists of tradi-prevention, who have turned their backs and say of PreP: 'it works like a vaccine, it's miraculous...'. What remains are the other STIs and the need to find an effective and economical prophylaxis for them. We'll come back to that...

- We have listed one more doctor, a long-time alleviator, whom we did not know: Dr. JEAN DEROUINEAU. That's it... Know how to take part in it

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Have a good Week end, Good back to school, good stuffing and not too many meds ... Huh?

Wednesday, August 1, 2018

112



This was originally published here, in French (link).
We provide this translation for your convenience. Practical aspects may differ where you live.




Are there many PTCs?

By Charles-Edouard!

Well, another false testimony...


What test? Specify... The false testimony is often: I have a friend of a friend who has tried lightening... I've broken it down here: True and False Testimonials. One mistake is to lump all lightening together. Just as there is not THE vaccination but Vaccinations (some work, some don't), there is not THE alleviation but ALLEGATIONS. Forget Mono-IP (mediocre and obsolete) or TRULIGHT (to be avoided), it's rubbish. Fortunately ICCARRE (and also Mono-DTG) works very well, even excellently.

Let's take a patient, rather allergic, with multiple resistances, happy on Eviplera®. Happy yes, but for how long? When the slow, pernicious renal toxicity sets in, then, for real, he has no nice options left. Another patient, with the same profile, has started to lighten Eviplera, progressively, step by step, she is at 3/7... She postpones the renal toxicity as much: Who wants to travel far spares his mount! So you have to ask yourself questions BEFOREhand. With a good doctor: I published a list


Let's go back to the PTCs: are they numerous?


We saw in the previous post what PTCs (Post-Treatment Controllers) are: they treat, interrupt for good, the virus rises and then falls back to a very very low set-point, undetectable. Are they cured? No, it only lasts for a while, 3 years on average. The situation of the Elite controllers is rather enviable, therefore, that of the PTCs too. If the proportion of PTCs was 100%, we would be saved; if, on the contrary, it is 0%, then it is big-Pharma that is saved. That's why we never tell you about it.

The hospital of Antwerp has identified 4 PTC among its 124 exploitable patient cases: 3%.
In the CHAMP cohort it is estimated at 3%. We have the same estimate (3%) by 2 different methods: let's keep this 3%. From a medical point of view stricto sensu, these people no longer need treatment.

Many useless tritherapies


So, we have a lot of people on AIE (Abusive Extension of Indication), about 25% (?), for whom the START trial shows that there is no clinical benefit, and for whom the only benefit is to become non-contaminated.
We have 3% who could do without treatment after having taken a treatment (of induction, of what? we will see that...), and 0.5% of Elite controllers who will be put, and maintained unnecessarily, under treatment, ad vitam.

When these patients realize this, they grumble, which is normal. Dr Hocqueloux presented the state of play in the Viscontis cohort (see poster, summary). It was the occasion to remind that the Visconti cohort is post-hoc (i.e. made up of patients, early treated, controlling the virus) but that we do not manage to obtain the PTC in the cohorts of very early treated patients. Based on his fragmented observations, Dr. Hocqueloux concludes: you have to treat them early, very early, and for a long time (to hope for TPC). But where does he get this from? Where is the proof??? In France, we have cohorts of early-treated patients, so go ahead, guys, show us that you have more than 3% of PTCs. The lack of clinical benefit of treating early, too early, is explained by Dr Ananworanich Favorable clinical phenotype achieved in less than half of those treated for acute HIV infection (see slides, abstract).

So, in summary, there are poor young people who are bored with treatments, with the promise of a possible post-treatment control, which has never been shown again(SPARTAC trial and even PRIMO cohort). In ordinary chronic patients, we have 3% of PTCs and in early treated patients, who have not developed any embryonic immune response: 0%. Hocqueloux can rant on and on, the problem is there: there is no statistical or clinical benefit for the patient to treat too early.

How to condition to get more PTCs


We find more PTCs in chronic patients than in PRIMO: it is not the fact of treating in Primo that is favorable, so... it is something else... That's what we need to focus on. And here, the new Eclipse Equation sheds light on this: if we improve the EpiGeneDist and/or Immune Response factors, we increase the Eclipse. One AND/OR the other.

The observation of the A5068 trial is that we can hope to increase the rate of PTCs from 3 to 15% (or even more...), by introducing time interruptions, of modest duration (1 month) repeatedly. This is more interesting to develop than this poor Hocqueloux who is watching the cows go by, without making any progress.

Are you a PTC who doesn't know it?


To find out, and in the absence of a predictive tool, the only way is to stop and look long enough at what is happening. If you are in the LOTTI test range, it's all good: if you are a PTC, you have won the prize, if you are not, you have, at least, benefited from the LOTTI interruption (very favorable procedure). If you are in the SMART bracket, let others do it, there are better things to do: ICCARRE

Or you have a clinician who is able to do a viral expansion test in blood bags: method proposed by Van Gulck (Antwerp). If the virus has difficulties to grow in the blood bag, while it only needs a few days in vitro(in vivo it takes a few weeks...), then maybe...

The real question is: are there methods to either increase the Eclipse or to increase the number of PTCs. The Shock-and-Kill will have disappointed: 3 methods are still in the running: vacation cycles (Ragon), DTG cycles (Wainberg), Short Cycles (Leibowitch)

PTCs, Eclipse, ICCARRE and DTG


Increasing the Eclipse is not the same as increasing the number of PTCS. These are 2 different objectives, and in my personal opinion, the search for a benefit for the patient makes it more important to use ICCARRE (1/7, Leibowitch) than Ragon (PTC, Bruce Walker). This is still interesting: because one can consider combining the methods: a TRI-protocol.

We will soon see the avenues open to us...

The universal French genius


Here is a rare intervention(youtube) of Pr Schinazi. Shina-Quoi? Yes, this is the occasion to remind you that he is the inventor of 3TC, F-3TC (which almost everyone uses) and ... Sofosbuvir (which cures you of HCV in a jiffy). His Wikipedia entry. Millions of lives saved, that deserves a tribute. Especially since his speech is rich. He reminds us: 'doing nothing has consequences'.

And to remind our brilliant ANRS, SFLS, CNS, and so on that there is no French molecule... Zero, Nada... That should make you a little more humble. No?

Link

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97% of patients overmedicated, 22 million without treatment... Let's stop this scandal!